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PT  - JOURNAL ARTICLE
AU  - Georgy, B.A.
TI  - Clinical Experience with High-Viscosity Cements for Percutaneous Vertebral Body Augmentation: Occurrence, Degree, and Location of Cement Leakage Compared with Kyphoplasty
AID  - 10.3174/ajnr.A1861
DP  - 2010 Mar 01
TA  - American Journal of Neuroradiology
PG  - 504--508
VI  - 31
IP  - 3
4099  - http://www.ajnr.org/content/31/3/504.short
4100  - http://www.ajnr.org/content/31/3/504.full
SO  - Am. J. Neuroradiol.2010 Mar 01; 31
AB  - BACKGROUND AND PURPOSE: Vertebroplasty is known for its high leakage rate compared with kyphoplasty. In recent preclinical studies, high-viscosity cements were shown to significantly enhance the uniformity of cement filling and decrease the incidence of leakage in cancellous bonelike substrates compared with low-viscosity cements. In this study, the incidence and pattern of cement leakage by using a new high-viscosity cement (Confidence spinal cement system) was compared with that of standard kyphoplasty. MATERIALS AND METHODS: Postoperative radiographs of patients treated with either kyphoplasty or Confidence were analyzed for cement leakage by using a stringent and thorough 4-point scale (none, minimal, moderate, or severe). When leakage was observed, the location of the cement leakage was also recorded and described as diskal, venous, paravertebral, or epidural. Sixty-two consecutive patients with 112 treated levels were included in this retrospective review. There were 46 kyphoplasty- versus 66 Confidence-treated levels, which ranged from T3 to L5. RESULTS: The average vertebral collapse reached 27.9 ± 20.7% in the Confidence group versus 25.0 ± 19.1% in the kyphoplasty group. There was no or mild leakage in 92% of Confidence and 91% of the kyphoplasty cases (mild, 39% Confidence versus 50% kyphoplasty). Severe leakage was only reported in 1 (2%) Confidence and 1 (2%) kyphoplasty case. In both cases, the severe leakage was found in the disk space. No significant leakage that required any surgical intervention was noticed. CONCLUSIONS: This finding confirms prior observations that highly viscous cements may increase the safety of vertebral augmentation techniques compared with less viscous cements. The high-viscosity Confidence cement results in a leakage rate comparable with that of kyphoplasty. PO2partial pressure of oxygenVCFvertebral compression fracture